What does vaginal bulge feel like with pelvic organ prolapse?

Some people describe a soft lump, dragging sensation, or the feeling that something is coming down. The sensation can be more noticeable later in the day, during coughing, lifting, or bowel movements, and may ease when lying down. Pelvic organ prolapse happens when support for organs such as the bladder, uterus, or rectum becomes less effective. A vaginal bulge has several possible causes, so its sensation alone cannot identify which structure is involved.

Arrange a pelvic health assessment if the bulge is new, persistent, or affecting walking, exercise, bladder control, bowel movements, or intimacy. Note when it appears, whether it changes with position, and any urinary or bowel symptoms. Avoid straining where possible, keep stools soft with fluids and fibre if suitable for you, and ask a clinician about pelvic floor physiotherapy. Treatment may involve observation, exercises, a pessary, or other options based on the examination and your goals.

Seek prompt medical care if the tissue is very painful, bleeding, ulcerated, or cannot be gently returned inside, or if you cannot pass urine. Urgent assessment is also appropriate for severe pelvic pain, fever, or sudden worsening. These features need assessment for irritation, infection, urinary blockage, or another pelvic problem.

Which pelvic organ may be contributing to the bulge? What examination will you need, and should it be done standing or while straining? Would pelvic floor therapy or a pessary suit your symptoms? Which changes should prompt an earlier review?